Minor Burns

"Burn" is a broader term than many think. Most people believe heat causes burns, but the medical definition of a burn has more to do with the depth of damage, not the cause. Burns can be thermal (from extremes of heat or cold), chemical (such as acid), or radiant (sunburn, x-rays or artificial ultraviolet rays from a tanning booth). All the mechanisms cause skin damage and you should treat them similarly.

Classifying Burns

Minor BurnsThe old "first, second, and third degree" naming system is still common with the public, but doctors now use the terms partial thickness and full thickness to describe burn injuries. Partial thickness burns don’t extend completely through the dermis; full thickness burns do (see diagram to compare classifications). Partial thickness burns (first degree and second degree) usually heal well and are easier to care for. This is because new skin can grow upward from the dermis; if the dermis is destroyed (full thickness or third degree burn), no skin can grow back in that area and deep scarring develops unless skin grafting is performed.

For the classic sun burn (first degree burn) with redness, slight swelling, and mild pain, home treatment is safe and works well for up to 50% of the body surface. Blistering burns (second degree) can be self-treated in many cases, but should be seen by a physician if:

  • More than 1% of your skin surface is involved (more than the size of the patient’s palm).
  • Face, neck, genital area, hands, or feet are involved.
  • Any child under 12.

You should never self-treat a full thickness burn, no matter how small. The risk of infection and scarring is too high.

Special Burns

Any electrical, steam, or inhalation burn (such as smoke, chemical, or extremely hot air or vapors) must be evaluated by a physician right away. These types of burns can have unusual complications despite mild symptoms at first.

Since nearly all burns are accidental, prevention is mostly a matter of basic safety --- avoiding extreme heat, caustic chemicals, etc. But there is one type of burn that people practically seek out: sunburn. Because it isn’t immediately painful, is associated with fun activities, and results in a pleasant skin tone if you don’t go too far, many people are willing to risk a little first degree burning.

That’s a big mistake. Both natural and artificial ultraviolet rays are extremely damaging to the skin. Everyone knows about premature skin aging and increased cancer risks, but you may not know that second degree burns with blistering and sometimes infection and scarring are very common with sunburn. Children especially must be protected from exposure. A simple application of level 30 sun block will prevent all of these problems.

There are literally dozens of medicines (both prescription and OTC) which make your skin more sensitive to the sun. Second degree burns can result with only brief exposure when your skin is sensitized by these drugs. Be sure to check with your doctor or pharmacist if you plan to be in the sun and are taking any medicine.

The most immediate treatment for both thermal and chemical burns is to stop the burn from progressing. Clothing saturated with caustic chemicals or hot substances should be removed at once, and the affected skin area placed in cold water (but not ice). If done within the first minute or so, cold water emersion for up to 30 minutes can reduce both the total area involved and the depth of the burn.

After these immediate measures, there are two treatment goals: relief of pain, and healing without scarring or infection. For first degree burns, you can easily achieve these goals with OTC pain relievers and a skin protectant/moisturizer for a few days. This prevents the delicate new skin underneath the burn from drying out, cracking, and peeling away with the burned skin layers on top of it. Topical anesthetics can help too (see Recommended Products section). Deeper burns require a lot more. Below is a standard burn dressing/treatment protocol for blistering second degree burns.

Depending upon the size and depth of injury, you may need to continue the above process for 1-3 weeks. When the new skin beneath the dressings is dry (but not crusty or scabbed) and no longer stings to touch, you can stop the dressings. The new skin is pink, thin, and delicate. You may choose to protect it for another week with a single layer of gauze wrap until it is sturdier.

Anti-inflammatory medication helps control pain, swelling, and redness. They should be dosed around the clock, with longer acting brands preferable since awakening in the middle of the night with burn pain is common with shorter acting medicine.

See the precautionary recommendations under Basics. In addition to these situations, if you notice any signs of infection, a physician should be consulted promptly. Many people worry needlessly about a yellowish or light green slime that covers raw second degree burns. This is part of the body’s normal response to a burn. The green/yellow color does not necessarily mean infection. Redness, swelling, pain and fever are much more reliable indicators of infection. You should be especially concerned about infection if redness starts to spread or enlarge in the days following the burn; normally, redness should shrink as the burn heals.

More than minor burns on our Self Care Home Page



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